The difficult doctor-patient relationship, rather than the difficult patient, is discussed by these authors also. This stems directly from their view of psychoanalysis as a science of the intersubjective, focused on the interaction of the subjective worlds of the observer and the observed. Transference and countertransference take on equal importance in this system. The authors believe the most common difficulties in treatment occur when conjunction of these subjective worlds escapes psychoanalytic scrutiny because it reflects a defensive solution shared by patient and analyst, and when an unrecognized intersubjective disjunction leads to chronic misunderstanding of the patient. The implications of this approach for the understanding of negative therapeutic reactions and for the treatment of patients with severe archaic psychopathology, e.g., borderline states, are clarified in detail.